If you’re caring for an older loved one, you might have come across the term “aging in place” as a reference to the practice of enabling the elderly to live out their lives in their own homes or communities versus nursing homes or assisted-living facilities.
In reality, aging in place (AIP) is simply the “ability to live in one's own home and community safely, independently and comfortably, regardless of age, income or ability level." It applies to anyone who requires or may someday require extended care — or who has loved ones that fall into that category. That applies to virtually everyone reading this article.
It’s true, however, that the practice of AIP has become increasingly popular with older Americans, and Baby Boomers in particular, for reasons that include reduced costs, increased autonomy, and continuity of social networks and health services, to cite a few. Roughly three out of four older adults express a desire to continue living in their homes and communities for as long as possible. With the number of Americans aged 65 or older predicted to double over the next three decades, the number of homes that will need to be retrofitted for AIP will grow as well.
The problem is very few homeowners have begun to plan for those changes. According to the National Poll on Healthy Aging, 85% of Americans between the ages of 50 and 80 haven’t thought about what home modifications AIP might require, and nine out of 10 U.S. homes currently fail to meet the criteria for “aging readiness” (i.e., having a step-free entryway, a bedroom and bathroom on the first floor, and at least one bathroom-accessibility feature).
So there may be a disconnect between older Americans’ attitudes and actions where AIP is concerned. To ensure your AIP plans are not derailed, check out the following needs-based AIP framework from Kerry Harp, senior sustainability analyst at Pearl Certification.
Map Out Short- and Long-Term Needs
Completing a successful AIP project requires time, planning, and, in all likelihood, at least some level of financial investment to implement the necessary home-performance improvements.
Fortunately, the first step is free: Take a moment to reflect on your current healthcare needs, or the healthcare needs of your loved one considering AIP, then decide which of the following scenarios seems like the most accurate description.
You or your loved one do not have urgent healthcare needs.
You or your loved one do not have urgent healthcare needs, but you or your loved one do have at least one chronic or progressive health condition — a disease, limitation, or impairment that does not improve over time.
You or your loved one have a traumatic-needs condition, such as a traumatic brain injury (TBI) or other sudden-onset situation requiring urgent care.
Have a clear idea of where you or your loved one fit into the above schema? Good — keep it in mind as we proceed. But first, Harp has one additional piece of advice to share.
“It’s a good idea to speak with the doctors who provide care for you or your loved one at this stage, before you’ve initiated any kind of AIP project, because they probably know best what you’re looking at and what to expect, from the standpoint of evolving health needs,” she says. “They can tell you how to spot warning signs, help you understand what red flags look like, connect you with physical and occupational therapists and others that specialize in AIP issues and solutions.”
An additional resource is a Certified Aging in Place Specialist (CAPS). A CAPS can access your existing home, propose improvement and adaptive measures, and recommend products to make your home safer and more accessible for short- and long-term needs.
Needs-Based AIP Home Prep for People With …
… No Urgent Healthcare Needs
If you or your loved one fall within this category, you may not feel particularly motivated to initiate AIP home-improvement projects right now. After all, what’s the rush? Who’s to say how your or your loved one’s specific health needs will shape up later on? Those who are planning for future needs have often become aware of the AIP needs by observing the needs of their aging parents.
“You have to think about and plan for AIP holistically,” Harp says. “Making changes based on principles that are referred to as ‘universal design’ is a really smart move. It’ll ensure that you have addressed accessibility, livability, and visit-ability issues and that whenever or however your needs change, you’ll be ready.”
Expanding on that slightly, universal design is a specific design framework that aims to create spaces that are usable by the widest possible range of people, regardless of their age, size, or disability status. And because universal design proceeds with an eye toward inclusivity and accessibility, a lot of its practices are directly applicable in the context of AIP.
A few straightforward examples:
Swapping out door knobs for levers
Lowering the placement of wall switches throughout the house
Widening all hallways, room openings, and doorways to at least 36 inches
Harp agrees, “Universal design is about a lot more than having the right handles on your doors or cabinets. It also considers things that would be easy to miss — an example being the color of your kitchen countertops versus the color of your kitchen floor. Is there enough contrast between those two colors and materials for someone with a visual impairment to quickly and easily distinguish one from the other and thereby safely navigate the kitchen? What if the person was color blind on top of that? These are exactly the ‘watchouts’ that universal design principles are so adept at helping you find and correct.”
What’s more, since universal design favors proactive and forward-thinking interventions, it’s also especially appropriate for people who may be transitioning to having more chronic health conditions and might be understandably eager to ensure their homes are AIP-ready.
… One or More Chronic Health Conditions
Roughly half of U.S. adults have at least one chronic health condition, which means this may well be the largest group considering home-improvement projects related to AIP. These conditions range from the normal aging process to progressive diseases and illnesses, with sensory impairments and mobility being the largest AIP barriers. In these cases, long-term home modifications may be necessary, and these modifications may need to be adaptable as the health condition progresses.
Along with home adaptation measures for AIP, there are other issues to consider, such as indoor air quality (IAQ). Contrary to what you might think, the concentration of pollutants is often much higher inside of your house than outside of it, according to the EPA, leading to negative health outcomes that range from mild irritation of the eyes and throat to headaches, respiratory disease, heart disease, and cancer — not a positive forecast for those whose health is already compromised and who often spend significant portions of time indoors.
“Taking simple measures to improve your IAQ would enhance an AIP project, and it’s the type of improvement measure that’s ideal for people in this chronic health condition group, as well as the other AIP segments. It’s going to lead to immediate home health benefits for all occupants,” Harp says.
Related Post: Breathe Easy by Improving Your Home’s Indoor Air Quality (IAQ)
… Traumatic-Needs Conditions Requiring Urgent Care
This need is for those who have experienced an abrupt and/or a traumatic event that results in a sense of urgency for immediate home modifications and accommodations needed with respect to their condition. Everything we’ve covered so far applies equally for people with traumatic-needs conditions requiring urgent care, except in the case of a traumatic event, there may not be time to plan for adaptive needs.
Harp advises, “AIP for someone with a traumatic-need, requiring urgent care, almost always necessitates somewhat extensive home-performance improvements — things that are beyond the scope of DIY. Additional finances may be required to address urgent needs, so careful decisions will need to be made in this critical time. Talk to multiple contractors and be selective about who you choose to work with. A Certified Aging in Place Specialist (CAPS) can often assist with choosing and working with a contractor.”
Home modification and renovation aside, people with traumatic-needs conditions requiring urgent care are probably also going to need reliable at-home assistance and healthcare services on a consistent basis. Beyond that, you’ll probably have to plan for and coordinate part- or full-time support in a number of other areas, such as:
Daily healthcare needs: How will the traumatic-needs conditions of you or your loved one be monitored and managed? What happens in an emergency?
Daily home maintenance and upkeep: What systems can you put in place to help maintain a clean, comfortable, and hygienic living space?
Daily food preparation: How will food be purchased and prepared?
Daily personal care: Who’s responsible for providing help with bathing, grooming, dressing in the morning, and getting ready for bed at night?
Financial management and oversight: What can you do to promote a sense of independence while safeguarding important resources? From a budgetary standpoint, Harp also recommends hiring support personnel on a part-time basis as much as possible in order to keep down costs associated with at-home health services.
Just bear in mind that you don’t need to seek service-based solutions for all or any of the above items. Don’t hesitate to ask family members, friends, relatives, and others to step up when they can and lend a hand.
Key Takeaways and Next Steps
AIP is an increasingly popular option for older Americans, one that will likely become even more popular as the country’s population grows older, but it isn’t attainable without careful planning, some level of investment, and action to bring it to life. As should be clear from the above, in the phrase “aging-in-place,” the operative word and point of emphasis is “place.” Equally, and bearing in mind the CDC’s broadly inclusive definition of AIP (“The ability to live in one's own home and community safely, independently, and comfortably, regardless of age, income, or ability level”), AIP isn’t just for the elderly, either.
If you’ve already worked with a CAPS or aging-in-place professional to create a plan for your or your loved one’s home, consider downloading the free Green Door app. Green Door can help you create home investment plans, find rebates and tax credits for energy-efficient home performance assets, connect with local, vetted contractors, and set maintenance reminders to keep equipment in top shape.
